Table 4 Summary of key findings: implementation and practicality
Area | Themes | Sub-themes |
|---|---|---|
Implementation | To what extent is SST being carried out in health facilities, and where? | |
SST | Pregnant women are being screened for malaria on their 1st ANC visit (regardless of symptoms); after the 1st visit, they will only be screened for malaria if they present with symptoms; SST is reportedly not being implemented at all or not consistently | |
SST at health posts/village level | Pregnant women are not being screened at health posts; only carried out at health posts if RDTs are available; pregnant women are told to go to health centres for screening; screening is being done at health posts using RDTs; in some village settings, only symptomatic women are being screened; challenges with implementation at village level: a) Limited RDT stocks or complete stock-outs; b) Lack of staff (trained staff, lab technicians) | |
RDT availability | RDTs have never been used; are not available/current stock outs for RDTs and previous stock outs across facilities/areas; RDTs expired before being used or facilities receiving RDTs close to expiry | |
Anti-malarial prescription at different facility levels | Anti-malarials not available at health posts; pregnant women must to go to health centres to receive treatment; treatment prescribed by a doctor; doctors and/or midwives provide pregnant women with prescription (at ANC); women collect anti-malarials from pharmacy; anti-malarials cannot be prescribed without confirmation from a diagnostic test for malaria | |
Practicality | To what extent is SST being carried out using existing resources? | |
RDT vs microscopy | Microscopy is main method of screening at health centres, or is used primarily but sometimes RDTs are used when the electricity is out or lab services are not available; when available RDTs are used for screening at health posts/sub health centres; RDTs are often administered by midwives, or lab technician (reported at one location); RDTs are not being used at health posts | |
SST at different levels of health facility | SST should be done at health posts as they are more accessible; SST at both health posts and health centres; at health centres as they have microscopes and staff; SST at all facilities is good if you have the resources; SST at home would be the best option | |
DP for treatment | DP is prescribed for treatment in 2nd and 3rd trimesters; DP stocks were mostly stable, but a few participants reported occasional stock outs; DP is well tolerated and effective; health provider concerns about completing doses of anti-malarials; DP has shorter dosing regimen than quinine, could be better for compliance |